Donor Abstract
| IDENTIFICATION NO. RR365 | DATE 04/2004 | ||||
PHYSICAL AND PERSONAL CHARACTERISTICS |
|||||
| DOB (M/Y) 08/1980 | PLACE OF BIRTH India | ||||
| HEIGHT 6'0" | WEIGHT 194 | ||||
| EYE COLOR Brown | COMPLEXION Fair, Asian | ||||
| HAIR Black, Straight | RIGHT HANDED X | LEFT HANDED | |||
| RELIGION BORN INTO Hindu | MARRIED No | NO. OF CHILDREN none | |||
| YRS OF COLLEGE 6 | OCCUPATION Engineering | HERITAGE Indian | |||
| INTERESTS Reading, books, puzzles, soccer and cricket | |||||
|
TEST RESULTS |
|||||
| Blood Type O Positive | HIV 1/2 Ab. & HIV 1 Ag. Nonreactive | ||||
| Chlamydia Negative | HTLV-1 Ab Nonreactive | ||||
| Chromosome analysis Normal male 46XY | Neisseria gonorrhea Negative | ||||
| Cystic Fibrosis Non carrier for 51 common mutations | SGPT Within normal limits | ||||
| CMV, IgM Nonreactive | Sickle cell Not applicable | ||||
| CMV culture No growth | Syphilis, antibody Nonreactive | ||||
| HbsAg & HbcAb Nonreactive | Tay Sachs Not applicable | ||||
| Hepatitis C, Ab Nonreactive | Thalassemia Normal adult hemoglobin | ||||
| Trichomonas & yeast None seen | HIV-1/HCV RNA Nonreactive | ||||
|
DONOR AND FAMILY HEALTH HISTORY |
|||||
| MEDICAL PROBLEM | DONOR | RELATIVE | |||
| HEART |
None |
Grandparent
- high blood pressure Uncle & Cousin - heart attack |
|||
BLOOD |
None | Grandparent - anemia | |||
| RESPIRATORY | None | Grandparent & Uncle - hay fever | |||
| GASTROINTESTINAL | None | Uncle - ulcer | |||
| METABOLIC/ENDOCRINE | None | Maternal grandfather - diabetes (not insulin dependent) | |||
| URINARY | None | None | |||
| GENITAL/REPRODUCTIVE SYSTEM | None | None | |||
| NEUROLOGICAL | None | Grandmother - migraines | |||
| MENTAL HEALTH | None | None | |||
| MUSCLES/BONES/JOINTS | None | None | |||
| SIGHT/SOUND/SMELL | None | None | |||
| SKIN | Acne as a teenager | Siblings & Cousins - non scarring acne as teenagers | |||
| OTHER | None | None | |||
|
FAMILY HISTORY |
|||||
| LEVEL OF SCHOOLING: | Mother MS | Father MS | |||
| OCCUPATION: | Mother Teacher | Father Engineer | |||
| AGE IF LIVING | AGE AT DEATH | CAUSE OF DEATH | |||
| MOTHER | 51 | ||||
| FATHER | 57 | ||||
| MATERNAL GRANDFATHER | 75 | Accidental death - car crash | |||
| MATERNAL GRANDMOTHER | 85 | ||||
| PATERNAL GRANDFATHER | 80 | Accidental death - car crash | |||
| PATERNAL GRANDMOTHER | 80 | ||||
| BROTHERS | 29 | ||||
| SISTERS | |||||